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474 NE 94 St (7)Name Address Company Phone # Inspection Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reque Date Typelnsp'n CIL Permit No. I-46 20(53 22S Ng2 414 NE, q s+ UnOed eQS } E5l£s- 7C3- 2 53 enfr 100 t1e-8104 BUILDING PERMIT APPLICATION FBC 2001 Tenant/Lessee Name $ Value of Work For this Permit Miami Shores Village Building Department sz' Permit Type (circle): Building Electrical Plumbing Roofing Owner's Name (Fee Simple Titleholder) S �CP / � Z - Phone # (log) - 7/ Fa Owner's Address 447Y- Nc 9 S f City IM (A-in ( S/4i - S State P Master Permit No. Zip 33 Off Phone # 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 J Permit No. 1-4 225 OJr Job Address (where the work is being done) 47 9c/ Sf City Miami Shores Village County Miami -Dade Zip 33 t 3 S Is Building Historically Designated YES NO • Contractor's Company Name Vii / Phone # Contractor's Address 58 r9 N r .71 , e_ City State e r Zip Qualifier SLOP 5-C64 t T Architect/En Name (if applicable) - Phone # Architect/Engineer's Address City State Zip Square Footage Of Work: Baths Number of: Bays Stories Families Bedrooms Type of Work: ❑Addition :Alteration :New Repa 'liplace 0 Demolition ���/ !� � � ,z Describe Wo k: K/ � Ad-- 0 ( ' - GFGU 7 ` /eGe 4 C 4 r- `/Y10Di& Pi) 1,446 4x04 c �) PRAINA 0 `f8O * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ SO P c _ v Z-1 is Permit Fee $ 4f (,— Notary $ Education/Training Fee $ .. 4 f) Tech $ "1 Scanning $ Radon $ Code Enforcement $ / f. ,, Bond $ Struct. $ 6 / y_ C (Continued on opposite side) Minus Plans Check Fee _ =;° _ e, Total Fee Now Due $ C �-`%� Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspec 1, • , t be approved and a reinspection fee will be charged. Signa C �IIY Q COMMISSION M;MP. R *Quit � * F * * * MY cammLSSION *#r�k rWWat P p,RY PV OFFICIAL NOTARY SEAC • NOTARY Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * ** :hc717 /03 wner or Agent 5a Signature NOTARY PUBLIC. Sign:. Print: My Commission Expires: Zip The '! going instrument was acknowledged b ore me this /5 The foregoin instrument was acknowledged before me this /J day o ' °, 2P.S, byckiSfi . n day of 2G 3 by -- oi who is personally known to me or who has produced who is personally known to me or who has produced As 'dentification and who did take an oath. / as identific • 'on and who did take an oath. ****************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ,� (Certificate of Competency Holder) �} State Certificate or Registration No 0.4 d- /5 , Certificate of Competency No. APPLICATION APPROVED BY: Plans Examiner + -.-- C7 1 Engineer Zoning iEM 4TH 1113 UNIT FEE ITEM . SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE • IDET LIGHT OUTLETS CENTRAL HEATING ISHWASHER RECEPTACLES A/C (WIND) ISPOSAL SERVICE TEWORARY A/C (CENTRAL) 'I SINKING FOUNTAIN SERVICE SIZE IN AMFS DUCT WORK LOOK DRAIN SERVICE REPAIR/ TER CHANGE REFRIGERATION REASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING NTERCEPTOR RANGE TOP UNDERGROUND TANKS AVATORY OVEN ABOVE GROUND TANKS AUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS LOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS .HOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS :INK, POT /3 COMP. MOTORS OVER 3- 5 If MECHANICAL VENTILATION :INK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES :INK, SLOP MOTORS OVER 8- 10 If ELEVATORS/ESCALATORS 'EMPORARY WATER CLOSET MOTORS OVER 10- 25 If FIRE SPRINKLER SYSTEMS JRINAL MOTORS OVER 25-100 HP COOLING TOWERS iATER CLOSET MOTORS OVER 100 If VIOLATION NDIRECT •WASTES A/C WINDOW RE INSPECTION LATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • 'HEATER -NEW INST. GENERATORS TRANSFIIiMiERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE ' SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES ;EWER CONNECTIONS SIGN TRANSFORMERS JTILITY -SEWER SIGN TIME CLOCK JTILITY -WATER FIXTURES ;EPTIC TANK ANTENNA IELAY TELEVISION OUTLETS )RAINFIELD, 4' TILE/RES. VIOLATION 'LIMP & ABANDON SEPTIC TANK REINS?ECTION SOAKAGE PIT CU. FT. ;ATCH BASIN )ISCHARGE WELL )OMESTIC WELL AREA DRAIN 300F INLET • SOLAR WATER HEATER ,, =IRE STANDPIPE 'OOL PIPING • _AWN SPRINKLER SYSTEM 3AS RANGE DETER SET (GAS) 3AS PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED.,' THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12 /19/2003 Applicant: JOSEPH PERZ Owner: PERZ JOSEPH JOB ADDRESS: 474 NE 94 ST Contractor UNITED RESTORATION Local Phone: 954 - 771 -6466 Parcel # 1132060140310 Signed: (INSPECTOR) Mechanical Permit Permit Number: ME2003 -225 Contractor's Address: 5819 N ANDREWS WAY Permit Status: APPROVED Permit Expiration: 6/13/2004 Construction Value: $2,800.00 Work: CHANGE EXISTING A/C Page 1 of 1 Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOT 3 & E1/2 LOT 4 BLK 51 LOT SIZE 75.000 Fees: Description Amount FEE2003 -8482 Building Fee $106.00 FEE2003 -8483 CCF $1.80 FEE2003 -8484 Training and Education Fee $0.60 FEE2003 -8485 Technology Fee $2.65 Total Fees: $111.05 Total Fees: $ 1 .g,0 Total Receipts: 10.00 ,),, ,c, I t (2s DEC 2 3 PAID -- DEC 2 2 PAID In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: MIAMI SHORES VI BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reque Date `D / t Type Insp'n Permit No. 2 -004 v 22, Name a)\ . Address 4 4 l AV , 014 Company s �� Phone # Inspection Date Approved Correction ❑ Re- Insp'n Fee ❑ . 1 CI 3..3 MIAMI SHORE VILLT GET BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reque t Date =7 / ev Type Insp'n, tE c t 32Z Permit No. r e e P ` ' , Name \ � e Address 4 We •` \ Company J ( )11 CA S 1, Phone # Inspection Date Approved Correction Re- Insp'n Fee ADDRESS 474 I. E. 94th St. LEGAL" 56,,, RECORD GARBAGE TAX PAID BY 1 YEAR ANNUL TAX PERIOD USED AMOIANT PAID DATE PAID NUMBER M. P.. z1Trtt R (0 3 S 3 a 1950 12.00 12 -31 -50 3.00 D-4 -55 15315 /97/ i 70d - aV 04/5 /o? .3/•5/ / owl. e-I, /- // - -1 - �rtr > 1 e, j. DeNo \r co (e) 7 -,o -sl /S / ° ° 47-93/-S.,-- / % , - .. .( ot 3 YE" / 4o1Y ,7, s! o a, (032 Application is hereby made for the approval of the detailed statement or me plans and specifications herewith submitted for the build • ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miarni Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progreu of the work. Date... —(I! ... f Z _.._�..._._ 19.g_ Owner's Name and Address ... .�C . `1'14 A.R. p .... • ._ No... 4 Street.t'V..� ( 29' _Tl ..._. Registered Architect and /or Engineer s tttt 33 138 co 3 / NG Name and address of licensed contractor..Q.�� �� ..�s . : � .... _4 400 (.v v � �.._... �. ..... ....7.�..� ......_.._..__ Locatio and Ip al of lot to be built on: /j Q / Lot NI + �y Block � l Subdivision.. : / 1 � ' .... // s � q 1� .._j ..... d3/0 T......_.. Street and Number where work is to be done State work to be done and purpose of building (by floors) ...__t L.).. S . T..ir). -4- At g - c o .p .. � . w l cT SYS:Teel PA-Lw S ,.... 5 f o t, Cj . 0 N 0 U ART 3T0 7 (- g A(R. dfll N DL 6-4Q- B w t7( g 461.- "4 and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost ol; improvements $ 2,. Gd Amount of Permit $. lone cubage required plan Cubage Distance .to next ne.uest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to.. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of Labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanent Sopffuleuuent, and has complied with the provisions thereof, and will require similar compliance frrun all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such ntractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks... (Signed) STATE OF FLORIDA. COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fads therein by him stated are true. Permit No.._. 01 _ ( Date Read, Sworn to and Subscribed before me. Disapproved (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Date. PLANNING BOARD DATE Chairman Member \icrr:ber Member c'A‘c- 2 ? a Notary Public, State of Florida Building Inspector My Commission Expires to me well known, \tembcr .. .. _....-- .--- ._..._._ ...._ Member ...._ �.._._..._...... __.. _...._ Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after apprmal has been obtained from the Pl.innir•g Board. A re tion fee of $L00 will be charged when such re inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.